This study will examine the efficacy of large doses of Methylprednisolone in the early treatment of acute spinal cord injury. The proposal is for a double blind randomized collaborative clinical trial at nine National Acute Spinal Cord Injury Centers. The Coordinating Center is at Yale University Medical School, Department of Epidemiology and Public Health. All eligible patients admitted to the Centers will be invited to take part in the study. Those consenting will be randomly assigned to standard or large doses of methylprednisolone (100mg versus 1000 mg daily for 10 days respectively). Neurological examinations will be performed on subjects at admission, and at six weeks, six months and one year after injury using standardized protocols and procedures developed during an extensive feasibility study. Differences in neurological function between the two treatment groups and the role of potentially confounding variables will be examined using loglinear models. It is expected that 150 patients in each treatment group will complete the study.